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      Statewide Assessment of North Carolina Nurse Practitioners' Knowledge of and Attitudes Toward Suicide Awareness and Prevention: Protocol for a Statewide Mixed Methods Study

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          Abstract

          Background

          Suicide is a major public health problem, which affects people of all ages and ethnicities. Despite being preventable, the rates of suicide have steadily climbed (more than a third) over the past 2 decades.

          Objective

          Nurse practitioners (NPs) must be responsible for recognizing suicide risk and providing appropriate treatment referrals in addition to having an important role in suicide prevention. The reasons why NPs may not pursue suicide prevention training are their lack of suicide awareness and prevention, limited experiences with suicidal patients, and the stigma associated with mental illness. Before we begin to address the gaps within suicide awareness and prevention skills, we need to first examine NPs’ knowledge of and attitudes (stigma) toward suicide prevention.

          Methods

          This study will comprise a mixed methods approach. First, quantitative data will be collected using the Suicide Knowledge and Skills Questionnaire and the Suicide Stigma Scale (Brief version) questionnaire. An email will be sent to the NPs explaining the purpose of the study. If they consent, they will click on a link to access the surveys on a secure site. In our previous research with this sample, email reminders to nonresponders after 2 and 4 weeks were sent. The quantitative component will be used to inform the qualitative interviews of this study. The Suicide Knowledge and Skills Questionnaire is a 13-item questionnaire comprising 2 subscales: suicide knowledge and suicide skills. All questions are rated on a 5-point Likert scale (1=completely disagree to 5=completely agree). The survey has been shown to differentiate between those with suicide training and those without and has a Cronbach α score of .84. The Suicide Stigma Scale ( Brief version) is a 16-item survey that assesses stigma regarding suicide. The items are measured on a 5-point Likert scale (1: strongly disagree to 5: strongly agree) and have a Cronbach α of .98.

          Results

          This study was funded by the Faculty Research Grants program through the Office of the Vice Chancellor for Research and Economic Development at the University of North Carolina at Charlotte. Institutional review board approval was obtained in April 2022. Recruitment occurred between summer and winter 2022. Interview conduction began in December 2022 and will conclude in March 2023. Data will be analyzed during spring and summer 2023.

          Conclusions

          The study results will add to the literature on NPs’ knowledge of and attitudes (stigma) toward suicide prevention. It represents a first step in addressing gaps within suicide awareness and prevention skills, among NPs in their respective practice settings.

          International Registered Report Identifier (IRRID)

          PRR1-10.2196/39675

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          Most cited references43

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          Statistical Power Analysis for the Behavioral Sciences

          <i>Statistical Power Analysis</i> is a nontechnical guide to power analysis in research planning that provides users of applied statistics with the tools they need for more effective analysis. The Second Edition includes: <br> * a chapter covering power analysis in set correlation and multivariate methods;<br> * a chapter considering effect size, psychometric reliability, and the efficacy of "qualifying" dependent variables and;<br> * expanded power and sample size tables for multiple regression/correlation.<br>
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            The outbreak of COVID-19 coronavirus and its impact on global mental health

            The current outbreak of COVID-19 coronavirus infection among humans in Wuhan (China) and its spreading around the globe is heavily impacting on the global health and mental health. Despite all resources employed to counteract the spreading of the virus, additional global strategies are needed to handle the related mental health issues. Published articles concerning mental health related to the COVID-19 outbreak and other previous global infections have been considered and reviewed. This outbreak is leading to additional health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger and fear globally. Collective concerns influence daily behaviors, economy, prevention strategies and decision-making from policy makers, health organizations and medical centers, which can weaken strategies of COVID-19 control and lead to more morbidity and mental health needs at global level.
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              Self-harm and suicide in adolescents.

              Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                2023
                7 March 2023
                : 12
                : e39675
                Affiliations
                [1 ] School of Nursing College of Health and Human Services University of North Carolina at Charlotte Charlotte, NC United States
                [2 ] Department of Public Health College of Health and Human Services University of North Carolina at Charlotte Charlotte, NC United States
                [3 ] William States Lee College of Engineering University of North Carolina at Charlotte Charlotte, NC United States
                Author notes
                Corresponding Author: Charlene Whitaker-Brown cdwhitak@ 123456uncc.edu
                Author information
                https://orcid.org/0000-0001-7174-7652
                https://orcid.org/0000-0003-0022-3346
                https://orcid.org/0000-0001-5641-653X
                https://orcid.org/0000-0002-8948-9601
                https://orcid.org/0000-0001-9465-6542
                Article
                v12i1e39675
                10.2196/39675
                10031437
                36881461
                01fa0e13-39be-4d86-a731-5478c1257f55
                ©Charlene Whitaker-Brown, Judith Bacchus Cornelius, Jaleesa Smoot, Anjala Khadka, Arundhati Patil. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 07.03.2023.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 20 May 2022
                : 8 September 2022
                : 29 December 2022
                : 31 December 2022
                Categories
                Protocol
                Protocol

                mixed methods,suicide awareness,suicide prevention,nurse practitioner,knowledge and skills,stigma,suicide,awareness,nurse,public health,treatment,prevention,metal health,mental illness,united states,skills

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